# Abstracts from the 4th JoPPP-Thailand 2025 Conference

## TL;DR

This paper presents multiple studies from a conference, covering topics like genetic influences on kidney transplant outcomes, complementary therapies in epilepsy, voriconazole pharmacokinetics in cancer patients, and usability of clinical decision support systems.

## Contribution

The studies introduce new insights into genetic polymorphism effects on transplant outcomes, sociocultural factors in complementary therapy use, voriconazole dosing in cancer patients, and CDSS usability evaluation methods.

## Key findings

- CYP3A5*3 and ABCC2 polymorphisms are linked to higher healthcare costs and graft rejection risks in kidney transplant recipients.
- Herbal medicine and prayer are commonly used complementary therapies among Malaysian epilepsy patients, with race and religion as significant predictors.
- A population pharmacokinetic model for voriconazole was developed, showing renal status and cancer type as key factors in drug clearance variability.

## Abstract

Tacrolimus is the gold-standard immunosuppressant for kidney transplant recipients (KTRs), but acute graft rejection and/or acute tubular necrosis (ATN) remain major clinical concerns. Genetic polymorphisms affecting drug metabolism may influence clinical outcomes and healthcare costs. This study investigated the impact of CYP3A5*3, ABCC2 -24C>T, and ABCC2 3972C>T polymorphisms on clinical outcomes (acute graft rejection and/or ATN) and cost-effectiveness in Malaysian KTRs.

This multi-centre, prospective observational cohort study involved ethnically diverse adult KTRs who consented and received tacrolimus-mycophenolate-prednisolone therapy following kidney transplantation between 2020 and 2021. DNA was extracted from patient blood samples using the Qiagen DNeasy kit. CYP3A5*3, ABCC2 -24C>T and ABCC2 3972C>T single nucleotide polymorphisms (SNPs) were determined by polymerase chain reaction (PCR). Incremental cost-effectiveness ratios (ICERs) were estimated by genotype.

Among 39 KTRs (mean age 32.2 ± 7.0 years), 23.1% experienced acute graft rejection and/or ATN. The median annual healthcare cost per patient was MYR 52,700, with significantly higher costs in CYP3A5*3 variant allele carriers (p < 0.001). Carriers of the ABCC2 24C wild-type (C allele) had a 27.7-fold higher risk of developing acute rejection or ATN (adjusted OR: 27.675, p = 0.038). The risk was further increased in patients with delayed graft function (adjusted OR: 49.214, p = 0.012) or a history of CMV infection (adjusted OR: 18.097, p = 0.009). Meanwhile, the cost-effectiveness analysis indicated that patients carrying the CYP3A5*1 wild type, ABCC2 -24C>T T variant allele, or ABCC2 3972C>T T variant allele may benefit from a more cost-effective transplantation management approach, as these genotypes were associated with a lower risk of graft rejection and ATN.

This study offers preliminary evidence linking ABCC2 -24C>T polymorphism to clinical outcomes in Malaysian KTRs, with initial findings suggesting potential cost benefits for specific genotypes. However, the results should be interpreted with caution and further research with larger and more diverse patient populations is needed to confirm these associations and guide personalised transplantation care.

Complementary and Alternative Therapies (CAT) are frequently used by people with epilepsy (PWE), often alongside conventional antiepileptic drugs (AEDs). While the clinical safety of such concurrent use remains uncertain, limited research has explored how sociocultural factors influence the use of CAT and treatment adherence. The objective of this study was to evaluate the prevalence and types of CAT used, assess the relationship between CAT use and AED adherence, and identify sociodemographic predictors of CAT use among PWE in Malaysia.

A cross-sectional study was conducted among 193 adult PWE recruited from hospital settings in Malaysia. A validated, self-administered questionnaire was used to collect data on CAT use, medication adherence, as measured by the Malaysian Medication Adherence Scale (MALMAS), and demographic characteristics. Data were analysed using chi-square tests and binary logistic regression.

A total of 83.2% of respondents reported using at least one form of CAT, with herbal medicine (61.2%), massage therapy (58.6%), and prayer (47.7%) being the most commonly reported. While overall CAT use was not significantly associated with AED adherence (p > 0.05), positive perception of massage therapy was significantly associated with better adherence (p < 0.001). Multivariate analysis revealed that race (Malay vs. others; OR = 2.18, p = 0.023) and religion (Muslim vs. non-Muslim; OR = 1.94, p = 0.035) were significant predictors of CAT use. No significant association was found with age, gender, or education level.

Although widespread, the use of CAT does not directly compromise AED adherence. However, specific beliefs, particularly those related to massage therapy, may enhance adherence, indicating a nuanced behavioural influence. Sociodemographic factors such as race and religion significantly predict CAT use. These findings underscore the importance of culturally sensitive patient counselling and pharmacist engagement to ensure the safe and informed integration of CAT in epilepsy care.

The pharmacokinetics (PK) of voriconazole have been reported in different populations and disease conditions. Cancer patients in Pakistan often exhibit considerable variability in plasma concentrations of voriconazole due to clinical, genetic, and environmental factors, presenting a challenge for effective dosing and therapy optimisation. This study aims to identify the factors that are responsible for the between-subject variability in the PK of voriconazole among cancer patients in Pakistan.

The therapeutic drug monitoring (TDM) data for voriconazole after intravenous administration were collected from the hospital's electronic records between January 1, 2023, and December 31, 2023. The cancer patients receiving intravenous voriconazole with available TDM data were included; patients with incomplete records or concurrent interacting medications were excluded. The development of a population pharmacokinetic (popPK) model was performed on NONMEM software. The effect of all available covariates on pharmacokinetic parameters was evaluated through stepwise covariate modelling (SCM). The model adequacy was evaluated using goodness-of-fit plots, bootstrap analysis (with 1000 replicates), and changes in the objective function value.

A one-compartment model with first-order elimination provided a more accurate description of the data for calculating pharmacokinetic parameters and conducting covariate analysis. The clearance of voriconazole was observed to be 6.17 L/h, with between-subject variability of 68%, while the value for volume of distribution was 55.9 L. The renal status of patients, as described by creatinine clearance (CRCL) and type of cancer, was a significant covariate for clearance, differing from previously reported determinants in other populations.

The developed popPK model can be used for individualised dose adjustment based on renal status and cancer type, potentially enhancing therapeutic efficacy and minimising toxicity in Pakistani cancer patients undergoing voriconazole treatment.

Clinical Decision Support Systems (CDSS) are computer-based applications that give patient-specific advice and evidence to support clinical decision-making. Usability is critical for the effectiveness and adoption of these systems in clinical environments. Poor usability can lead to user frustration, inefficiencies, and increased error rates, ultimately resulting in system abandonment. This narrative review discusses current practices used to evaluate the usability of Clinical Decision Support Systems (CDSS).

Forty-three peer-reviewed studies published between 2015 and 2025 were reviewed and synthesised. Each study was examined for the evaluation methods employed, the usability tools utilised, and the types of outcome measures reported. The review also compared whether the studies used single approaches, such as surveys alone, or combined strategies that integrated quantitative and qualitative methods. Additionally, it identified emerging trends, strengths, and limitations in usability assessment.

Most studies relied on user trials (41 studies), and the System Usability Scale (SUS) was applied in 32 studies. Several types of qualitative methods were used, including interviews (12 studies), thinking-aloud protocols (9 studies), comparative usability testing (8 studies), heuristic evaluation (4 studies), and observation (3 studies). Only three studies utilised advanced tools, such as eye-tracking or Morae, indicating that automated evaluation methods remain uncommon. The most frequently measured aspects were satisfaction, usefulness, efficiency, and error rates. Less attention was given to learnability and effectiveness, which are essential for long-term system use. While many studies employed mixed methods, eight relied solely on quantitative surveys, which limited the depth of findings and the generalizability of the results.

The results suggest that CDSS usability evaluation remains inconsistent. A standard framework is needed that combines user feedback with performance-based data and encourages triangulated methods. These findings underscore the importance of incorporating usability testing into the development process for system designers. Additionally, healthcare policymakers should consider usability standards when encouraging the adoption of digital health technologies. By implementing these measures, we can enhance the integration of Clinical Decision Support Systems (CDSS) into clinical practices, ultimately leading to safer and more effective patient care.

Self-monitoring of blood glucose (SMBG) and self-adjustment of insulin doses are critical for optimal diabetes self-management. However, the lived experiences and multilevel determinants influencing these practices remain underexplored. This study aimed to explore the experiences and determinants of sustained SMBG adherence and insulin dose self-adjustment among patients with diabetes in primary care, guided by the Social Ecological Model (SEM).

A qualitative study was conducted in Malaysia between September 2024 and January 2025, involving 14 patients with type 2 diabetes mellitus who were receiving insulin therapy. Data were collected using semi-structured interviews, which were audio-recorded and transcribed verbatim. A thematic analysis approach was used to analyse and interpret the data.

The analysis revealed two main themes on patient experiences: the perceived purpose of SMBG and its practice with insulin dose adjustment. Patients used SMBG to obtain tangible glucose readings guiding decisions on insulin dosing, diet, and lifestyle. Practices varied from regular monitoring to symptom-driven checks, with insulin adjustments often based on personal interpretation. Four themes with 11 subthemes emerged as SMBG determinants under the SEM framework: (i) individual factors knowledge, routine, perceived importance, financial status, physical/cognitive ability; (ii) interpersonal factors family and healthcare provider support; (iii) community/organisational factors local community, peer, and workplace support; (iv) policy factors – accessibility of SMBG equipment. Facilitators included formal education, motivation, sense of responsibility, and financial stability. Barriers spanned intrapersonal (knowledge gaps, forgetfulness, technical difficulties), interpersonal (limited support), community/organisational (negative peer perceptions), and policy levels (limited equipment access).

Patients’ experiences and practices of SMBG and insulin dose self-adjustment are shaped by multiple, interacting determinants across SEM levels. Effective interventions must holistically address barriers while strengthening facilitators, through tailored education, continuous support, and integration of SMBG into daily routines to sustain adherence in primary care.

This study aimed to assess the compounding practices of sterile preparations in the PICU of a referral hospital.‏

The evaluation involved observing nine critical components of the compounding process, using a checklist based on the USP <797> standards and the Basic Guidelines for Sterile Preparation Dispensing. The most frequently prepared sterile products were then tested for microbial sterility using fluid thioglycollate medium and soybean casein digest medium.

Among the 19 types of sterile product compounds examined, nonconformities were identified in the following areas: compounding personnel (100%), facility infrastructure (100%), equipment (60%), aseptic technique (100%), labelling (60%), storage (50%), distribution (100%), and quality assurance (100%). Only the packaging aspect showed full compliance (0% noncompliance). Furthermore, sterility testing indicated microbial contamination in products compounded within the PICU. These findings suggest that most critical aspects of sterile compounding at this PICU of referral hospital do not align with USP <797> and national sterile preparation guidelines, with the exception of packaging.

Microbes identified as contaminating the compounded products in PICU are Staphylococcus aureus bacteria and Candida albicans fungus. Therefore, substantial improvements across several key areas are necessary to enhance the safety and microbiological quality of compounded sterile preparations.

The rise of hospital-acquired infections caused by multidrug-resistant organisms (MDRO) has increased healthcare burden, patient morbidity, and mortality. At the same time, existing risk assessment tools lack applicability across different populations. Multiple risk factors for infections caused by MDROs have been reported in the literature, though specific populations often influence them. To identify risk factors based on the UAE population and determine any potentially new factors to help detect hospital-acquired infections caused by MDRO in ICU patients.

This ongoing research project is designed as an observational, retrospective case–control study, conducted in three centres across the UAE, to identify prevalence rates and potential independent risk factors for MDRO infections. Patients admitted to the ICU for more than 24 h for a hospital-acquired infection were included. Risk factors for MDRO infections were identified from the patient data. Student t-test was used for parametric variables, Kruskal–Wallis test for non-parametric variables, and Chi-square test for nominal variables, all used wherever applicable at alpha = 0.05

In the UAE, the prevalence of MDRO among gram-negative bacteria has been reported at 35.8% for ESBL E. coli, 25.3% for ESBL Klebsiella pneumoniae, and 14% for Pseudomonas aeruginosa. Initial study findings from a feasibility study have identified several potential risk factors, including the presence of a tracheostomy tube throughout the ICU stay, enteral feeding tube, use of a central line, and transfer from another hospital ward, that increase the risk of MDRO infection by twofold or more in critically ill patients. The ongoing research will continue to identify additional risk factors and associate these factors with the development of infections caused by MDROs, as well as the pattern of antibiotic use.

Using local epidemiology data to determine the associate risk factors with infections caused by MDRO can be helpful in early identification of high-risk patients and improves further clinical decisions in therapy.

Vitamin D plays a crucial role in immune regulation, and its deficiency has been increasingly linked to the development of autoimmune disorders. This study examined the relationship between vitamin D deficiency and the incidence of autoimmune diseases among hospitalised adults in Central Jakarta.

A prospective cross-sectional study was conducted from July to August 2025, involving 45 adults in the productive age range (18–60 years) recruited from the Islamic Hospital Jakarta Cempaka Putih and YARSI Hospital. Data collected included age, gender, comorbidities, and serum 25(OH)D levels. Vitamin D status was categorised as deficient, insufficient, or sufficient. Chi-square tests were performed to assess the association between vitamin D status and clinical variables, including autoimmune disease occurrence.

Of the 45 participants, eight were male (18%) and 37 were female (82%), with a mean age of 32 ± 7 years. Most participants had no significant comorbidities. Vitamin D assessment revealed that 32 participants (71%) were deficient, 7 (16%) were insufficient, and 6 (13%) were sufficient. Chi-square analysis revealed a significant association between age group and vitamin D levels (p < 0.05), while no significant correlation was found between gender and comorbidities. Importantly, vitamin D deficiency was significantly associated with the occurrence of autoimmune disease (p < 0.05), supporting its role as an immunomodulator.

Vitamin D deficiency is highly prevalent among adults in Central Jakarta, particularly among those with autoimmune diseases. A significant association exists between vitamin D status and the occurrence of autoimmune diseases. Routine assessment of vitamin D levels, supplementation, and lifestyle interventions are recommended as preventive and therapeutic strategies for autoimmune diseases.

Sarcopenia (the age-related loss of skeletal muscle mass and function) is a central geriatric syndrome associated with increased disability, reduced quality of life, higher healthcare utilisation, and higher mortality. Despite the burden of sarcopenia as a significant health issue among the Malaysian elderly population, the influence of medication-related factors on its development remains understudied. This study aimed to determine the prevalence of sarcopenia and its association with drug classes as well as specific medication-related factors (i.e. polypharmacy, potentially inappropriate medications, and anticholinergic burden) among geriatric outpatients in a Malaysian tertiary care setting.

A cross-sectional study was performed between January and April 2025. Two hundred fifty-eight patients were recruited at a Malaysian geriatric specialist outpatient clinic. Sarcopenia was diagnosed using criteria from the Asian Working Group for Sarcopenia (AWGS) 2019. Medication data were extracted from hospital pharmacy records. Multivariate logistic regression was used to identify associations between sarcopenia and drug classes, as well as sarcopenia and specific medication-related factors (i.e. polypharmacy, potentially inappropriate medications, and anticholinergic burden).

The prevalence of sarcopenia in this study was 15.9%. While this figure was substantial, it is lower compared to previous Malaysian studies. The outpatient population in this study may already have more intensive multidisciplinary interventions, contributing to lower prevalence. Two drug classes were significantly associated with sarcopenia, i.e. drugs used in BPH, and calcium, although they were not statistically significant after adjusting for confounders. Calcium was also significantly associated with low physical performance, although this association was no longer significant after adjustment. This suggests the observed association may have been confounded by clinical factors rather than reflecting a genuine causal relationship, and warrants further in-depth longitudinal investigation. The presence of polypharmacy was significantly associated with low muscle strength, even after adjusting for confounders, which is consistent with previous research.

15.9% of geriatric patients met the AWGS 2019 criteria for sarcopenia. Polypharmacy was significantly associated with the development of sarcopenia-related outcomes, i.e. low muscle strength. Further longitudinal research should focus on the specific medication classes identified and explore the effectiveness of strategies to target polypharmacy to mitigate sarcopenia risk in the elderly.

Geriatric patients with kidney diseases face a significantly increased risk of potentially inappropriate medication (PIM) events due to age-related physiological changes, altered pharmacokinetics, polypharmacy, and decreased renal function affecting drug efficacy and safety. The STOPP START criteria provide evidence-based guidelines designed explicitly for identifying PIMs in older adults. This study aimed to examine the treatment profile, incidence of PIMs, and associated factors based on STOPP START criteria in geriatric patients with kidney diseases.

This cross-sectional study employed retrospective data collection with total sampling from medical records of geriatric patients with kidney diseases at Undata Palu Hospital from 2022 to 2023. Patients aged 65 years and older with documented kidney disease were included. PIMs were assessed using the STOPP START criteria, version 2. Demographic data, clinical characteristics, medication profiles, and laboratory parameters were collected. All data were analysed using univariate descriptive statistics and bivariate analysis (chi-square test) to examine associations between PIMs and patient characteristics.

Of 79 eligible patients, 29 patients experienced PIMs, representing a considerable incidence rate. The most frequently identified PIM was NSAID use among patients with GFR <50 ml/min/1.73m2 (17 events, comprising 48.57% of total PIMs). Other common PIMs included inappropriate use of proton pump inhibitors and cardiovascular medications. Chi-square tests revealed no significant association between PIM incidence and the tested patient characteristics, including gender, age, length of stay, and polypharmacy (p > 0.05).

The incidence of PIMs in kidney-impaired geriatric patients at Undata Palu Hospital is considerable. None of the tested patient characteristics were associated with PIM incidence; however, a larger sample size and consideration of additional factors such as specific medication classes and comorbidities are warranted. Regular medication reconciliation and greater clinical pharmacist involvement in geriatric nephrology care may help reduce PIM incidence and improve patient outcomes.

Hypertension is a condition where blood pressure in the body increases from normal (120/80 mmHg) or reaches (140/90 mmHg). Patients suffering from hypertension must take medication for life, so drug safety, which includes monitoring the effectiveness and side effects of the antihypertensive drugs consumed by patients, needs to be considered. This objective is to determine the side effects of antihypertensive drugs that may occur in hypertensive patients.

The method used in this study was a systematic literature review, where researchers conducted internet searches (using Google, Scholar, ResearchGate, etc.) and screened and selected relevant research articles from Indonesia. The keywords used by researchers were ‘Side Effects, Hypertension, Drugs, Antihypertensive’ with a focus on the last 5 years. They then analysed and synthesised the findings from various research articles to produce a result.

Hypertension patients are often between the ages of 56 and 65 years, with women being more commonly affected. In the ACEI class, a common side effect is a dry cough, which is caused by an increase in bradykinin. Other side effects may include itching/skin rash, and swelling due to allergies, with an incidence reported in 4-7% of patients. Common side effects in the CCB class include peripheral edema/swelling due to fluid accumulation in the interstitial space caused by hemodilution. Other side effects may include dizziness due to decreased blood pressure and itching, with an incidence reported in 12% of patients. Reactions include redness (10%) and excessive gum growth (21%). Common side effects of ARBs include hypotension, renal dysfunction, and hyperkalemia. Other side effects may include pulmonary complications. In patients with myocardial infarction, beta-blockers (bisoprolol) have been associated with side effects such as fatigue, dizziness, and wheezing. Diuretics (furosemide and bumetanide) have adverse side effects, including arrhythmia complications, hyponatremia, renal dysfunction, and metabolic alkalosis.

This study concludes that each class of antihypertensive drugs can cause various side effects such as dry cough, indigestion, hyperkalemia, peripheral edema, and others.

Hypertension in adolescents is an emerging global health concern, yet a comprehensive synthesis of empirical findings remains limited. This study aimed to conduct a systematic literature review and bibliometric analysis of hypertension in adolescents to identify research trends, contributing factors, and implications for the prevention and management of the condition.

A systematic literature review was performed using the Scopus database with the keyword ‘Hypertension in Adolescents’ applied to article titles, abstracts, and keywords. A total of 77 publications from 2021 to 2025 were retrieved, of which 51 met the inclusion criteria (English language, adolescents ≤19 years, original articles). Data were analysed bibliometrically using VOSviewer, with sociodemographic and thematic mapping.

Among the 51 included studies, 11 originated from China, eight from the United States, and six from Brazil, representing the leading contributors to this field. Most study populations involved adolescents aged 15–17 years, with fewer studies addressing younger adolescents. The co-occurrence keyword analysis highlighted Hypertension, Adolescents, Blood Pressure, Obesity, Systolic Blood Pressure, and Body Mass Index as the most frequent terms. Five major categories of contributing factors were identified: lifestyle and behaviour, genetics and family, anatomical and physiological, demographic and anthropometric, and psychosocial and environmental. Among these categories, lifestyle and behavioural factors – including lack of physical activity, smoking, unhealthy diet, poor sleep, and digital addiction – emerged as the most common contributors.

Hypertension in adolescents is influenced by multifactorial determinants, with lifestyle and behaviour identified as the leading contributors. These findings emphasise the importance of early prevention through health education, lifestyle modification, and evidence-based pharmacological and non-pharmacological interventions. Strengthening research in underrepresented regions is also recommended to broaden global insights into adolescent hypertension.

Tuberculosis remains one of the most serious infectious diseases worldwide and continues to impose a high burden on public health in Indonesia. Strengthening the effectiveness of TB treatment services is crucial to achieving national and global elimination targets. Tuberculosis remains a significant challenge for both global and national public health. A systematic evaluation of TB treatment services in health care facilities is essential to assess treatment outcomes and progress toward national targets. Therefore, this study aimed to review and analyse the literature on TB treatment services in Indonesia, with a particular focus on service delivery, drug management, patient adherence, and technological innovations.

Relevant articles were retrieved from PubMed, ScienceDirect, ProQuest, and Google Scholar using the keywords ‘tuberculosis’, ‘medication services’, ‘adherence’, ‘treatment outcomes’, and ‘Indonesia’. The initial search identified 356 records. After removing duplicates (n = 52), 304 articles remained for title and abstract screening. A total of 210 articles were excluded as irrelevant. Of 94 full-text articles assessed, 49 were eliminated due to methodological limitations or lack of relevant indicators. Finally, 10 studies met the inclusion criteria.

The systematic review demonstrated that the effectiveness of TB treatment services can be assessed through several quantitative indicators. An intervention known as Kopi TB at Banjarmasin Indah Primary Health Center improved the cure rate from 86% to 93%. Patient adherence remains a critical challenge; a study in Sragi Primary Health Center, Lampung, reported that only 59.2% of patients were adherent, while 40.8% were non-adherent. According to the Ministry of Health of Indonesia and the Global TB Report 2024, approximately 125,000 TB-related deaths occur annually in the country. Relapse and treatment interruption were also reported, such as at Kauditan Primary Health Center, North Minahasa, where eight cases of treatment dropout and multidrug-resistant TB were identified. Laboratory indicators, such as sputum conversion, were suboptimal; in Central Java Province, the sputum conversion rate was 83.5%, which is below the national target of greater than 90%.

TB treatment services in Indonesia have shown substantial progress but continue to face gaps in patient adherence and system capacity. A multidimensional approach integrating clinical practice, patient education, and digital innovation is recommended to strengthen TB control and achieve national health targets. This review did not have a registered protocol, which is acknowledged as a limitation since the absence of protocol registration may reduce transparency and replicability.

This study aimed to (1) assess the level of Rational Drug Use Literacy (RDUL), defined as individuals’ ability to access, understand, decide, and apply information related to safe and appropriate drug use, among Village Health Volunteers (VHVs) in Pathum Thani Province, Thailand; (2) examine the influence of situational factors (SITU) and social-environmental factors (SENV) on RDUL; and (3) explore the mediating role of SENV in the relationship between SITU and RDUL.

A quantitative, cross-sectional design was employed involving 160 VHVs. Data were collected using a structured questionnaire developed initially by the Health Systems Research Institute (HSRI), which was adapted to include additional constructs that measured situational and social-environmental factors. Descriptive statistics (mean, standard deviation, frequency, and percentage) were used to describe participant characteristics and core variables. Structural Equation Modelling (SEM) was applied to test hypothesised relationships, including both direct and indirect effects.

Findings revealed that RDUL among VHVs was insufficient, with overall scores falling below the desired competency level. The mean scores for SITU (Mean = 3.35, SD = 0.66) and SENV (Mean = 3.32, SD = 0.57) indicated moderate influence. SEM results showed that SITU had no direct effect on RDUL (β = 0.067, p = 0.430), while SENV had a significant direct effect on RDUL (β = 0.415, p < 0.001). Additionally, SITU significantly affected SENV (β = 0.695, p < 0.001) and had an indirect effect on RDUL through SENV (β = 0.289, p < 0.001), confirming the mediating role of social-environmental factors.

The study highlights inadequate RDUL among VHVs and the mediating role of social-environmental factors in the relationship between situational factors and RDUL. Strengthening communication networks, improving access to consultations, and enhancing community service infrastructure are essential. Public health policies should support social services and empower VHVs as key agents for rational drug use. Future research should expand RDUL assessments to include digital health literacy and evaluate interventions across diverse populations to inform broader policy integration of RDUL into community-based health promotion strategies.

To improve efficiency and transparency in medicine procurement and price control in Indonesia, the government implements e-procurement systems. In addition, to strengthen the resilience of pharmaceutical raw materials, policies mandate the procurement of medicines with a specified domestic component level (TKDN). This study aims to identify the alignment and gaps between regulations and implementation, and to observe the procurement trends of TKDN-valued medicine in the e-catalogue system.

A regulatory review was conducted on policies from the related ministries and agencies. In-depth interviews were held with seven key informants, three from the pharmaceutical industry (state-owned and private companies) and four from healthcare facilities (public and private hospitals). Informants provided insights into TKDN compliance and experiences in the procurement process. Quantitative cross-sectional analysis of procurement data (2021–2023) from the LKPP database complemented the qualitative findings.

There were overlapping regulations because they were issued by different ministries/agencies without full synchronisation. Overlapping regulations created implementation barriers: TKDN rules mandate the use of local raw materials, but smaller production scales make them more expensive than widely produced imports, thereby raising overall medicine prices. Industries also face additional certification costs, which are valid for only two years. Healthcare facilities responded differently; public hospitals prioritised TKDN compliance under Presidential Regulations, while private hospitals emphasised price efficiency for financial sustainability. Procurement data revealed decreasing reliance on non-TKDN products (53% of items in 2021 to 30% in 2023; procurement value from 60% to 19%), alongside growth of medicines with partial TKDN (25–40% value share increased from ∼30% in 2021–2022 to 52% in 2023). However, medicines with TKDN >52% remained stagnant (1.3–1.9% of items), and their procurement value fluctuated, rising sharply in 2022 before dropping in 2023. Only Simvastatin and Paracetamol reached >52% TKDN, yet Simvastatin's e-purchasing share declined steadily (16% in 2021, 10% in 2022, 0% in 2023).

The predicted increase in the price of TKDN-based medicines is expected to align with the growth of the national health budget. In contrast, procurement regulations required healthcare facilities to ensure cost-efficient purchasing. Researchers suggest aligning TKDN incentives with fair BPJS premium adjustments and harmonising procurement, pricing, and industrial policies to support both local production resilience and sustainable access to affordable medicines.

Issues arising from an inappropriate pricing policy impact patients’ access to high-quality medicines. This study aimed to (1) Examine the trend of antidiabetic drug procurement prices from 2018 to 2022; (2) Compare these procurement prices with the median reimbursement prices set by the Comptroller General's Department and the National Health Security Office (NHSO); and (3) Analyse the potential impact on patient access to medications as well as the financial burden on hospitals under the Ministry of Public Health.

Drug procurement price data from the Comptroller General's Department database for the period 2018–2022 were utilised and categorised according to the Anatomical Therapeutic Chemical (ATC) classification system. Data analysis was conducted using Microsoft Excel version 2016. Descriptive statistics, including percentages, medians, and means, were reported.

A total of 148,421 procurement records of antidiabetic drugs (ATC code A10) were analysed and categorised into 480 Trade Product Use (TPU) codes. The majority were generic drugs procured alongside originator drugs, accounting for 282 TPUs (59%); followed by originator drugs alone, at 112 TPUs (23%); and originator drugs procured alongside generic alternatives, at 52 TPUs (11%). (1) Trends of procurement prices between 2018 and 2022: It was found that original drugs without generic drugs trended to increase, and generic drugs trended to decline. After the entry of generic drugs, the original drugs with the same GPU would reduce their price to be close to that of the generic drugs. (2) When categorised by GPU codes, a total of 124 GPU codes were identified, of which 85 GPUs (68.55%) had median price references. Of these, procurement prices for 52 GPUs (61.18%) were cheaper than the median price, 17 GPUs (20.00%) were equal to the median price, and 5 GPUs (5.88%) were higher than the median price. Procurement prices in 2022 were generally lower than reimbursement prices, including the NHSO fee schedule and the Comptroller General's Department fee for service.

The findings of this study highlight the importance of having generic drugs to reduce the price of original drugs, thereby making them more accessible, and establishing appropriate median and reimbursement price policies to ensure the financial stability of hospitals in Thailand. Moreover, a mechanism to track price changes and adjust reimbursement pricing for drugs that have been set too low should be established to ensure that the reimbursement system is effective and does not impose an ongoing burden on hospitals.

Cancer poses a considerable health and economic burden globally, being a leading cause of death and morbidity worldwide, with China being no exception. While China's basic medical insurance (BMI) programme has expanded outpatient coverage for chronic diseases, including cancer, there is a lack of national-level guiding policies. This study aims to investigate disparities and inequities in outpatient cancer reimbursement across China by analysing reimbursement policies in different cities and under different medical insurance schemes.

We conducted a cross-sectional analysis of outpatient reimbursement policies for cancers in China in 2022, supplemented by a longitudinal policy analysis covering 2015, 2019, and 2022. A representative sample of 85 prefecture-level cities was selected, including all four municipalities directly under the central government, provincial capitals, and two additional cities per province (with the highest and lowest GDP per capita in 2022). Data were systematically collected from official websites of medical insurance bureaus, finance bureaus, and people's governments. We analysed three key indicators – deductible threshold, reimbursement ratio, and reimbursement cap – under two insurance schemes: The Urban Employee Basic Medical Insurance (UEBMI) and The Urban and Rural Resident Basic Medical Insurance (URRBMI). Descriptive statistics, paired samples t-tests, and Spearman correlation analysis were employed to assess disparities and correlate them with local GDP per capita.

Significant differences were observed in reimbursement caps and ratios between the two medical insurance schemes (P < 0.005 and P < 0.001, respectively). Only the reimbursement cap was positively correlated with GDP per capita under both schemes (rs = 0.27, P = 0.01 for UEBMI; rs = 0.36, P = 0.001 for URRBMI). Longitudinally, sample cities showed unchanged or lower deductible thresholds, while reimbursement ratios and caps either remained unchanged or increased.

National guidelines for outpatient cancer reimbursement are necessary in China to facilitate local policy refinement and enhance the level of outpatient reimbursement, thereby promoting healthcare accessibility and equity.

The swift advancement of artificial intelligence (AI) and digital health innovations presents significant opportunities alongside regulatory challenges for national pharmaceutical frameworks. Numerous ASEAN nations currently lack adaptable structures to guarantee the secure, ethical, and practical implementation of AI within pharmaceutical practices. This research aims to develop a progressive Pharmacy Policy 5.0 framework that integrates intelligent regulation to stimulate innovation while protecting public health, data integrity, and patient safety.

A mixed-methods policy analysis was conducted through a Systematic Literature Review (120 publications, refined to 53 via PRISMA), policy benchmarking across five ASEAN nations, and Delphi with foresight methods to validate insights, identify regulatory gaps, and anticipate challenges in AI and digital health implementation.

The analysis identified four pivotal deficiencies: (1) the lack of defined AI validation standards within pharmacy, (2) limited utilisation of big data for pharmacovigilance, (3) inadequate adoption of blockchain technology for supply chain transparency, and (4) a deficit in digital competencies among pharmacy professionals. In light of these insights, five strategic pillars were recommended within the Pharmacy Policy 5.0 framework: (i) intelligent regulation and interoperability, (ii) big data-driven pharmacovigilance, (iii) blockchain-enhanced supply chain, (iv) ethical governance for pharmacogenomics and precision medicine, and (v) the development of digital competencies for pharmacy practitioners.

Pharmacy Policy 5.0 provides an adaptable framework to modernise pharmaceutical governance in the era of AI and digital health, emphasising collaboration among regulators, innovators, and pharmacy stakeholders to build resilient, patient-centered healthcare systems.

Since 2022, common illness (CI) care services have been implemented in community pharmacies under the Universal Health Coverage (UHC) scheme in Thailand. This initiative aims to enhance access to primary care, alleviate hospital congestion, and enhance the role of pharmacists in the community. This study aimed to review the implementation of the CI care policy in Thailand.

A scoping review was conducted based on Arksey and O’Malley's six-stage framework, with adaptations from the Joanna Briggs Institute. A systematic search was performed for materials published between January 2022 and December 2024 in PubMed, Scopus, and ThaiJO. Additional grey literature sources included Google Scholar, reports from the National Health Security Office (NHSO), and Ministry of Public Health documents. The search strategy used MeSH terms and keywords related to ‘community pharmacy,’ ‘common illness care/minor ailments,’ and ‘universal health coverage’ in the Thai context. Eligible materials included service guidelines, official announcements from the NHSO and the Pharmacy Council, operational and monitoring reports, meeting records, peer-reviewed research articles, and other relevant grey literature. Two reviewers independently screened all records, with disagreements resolved by a third author. Content analysis was applied to synthesise findings and provide an overview of policy implementation, as well as to identify gaps.

The CI care service currently covers 32 groups of symptoms and follows standardised procedures, including eligibility verification, history taking, symptom assessment, medication dispensing, counselling, and follow-up within three days. The programme is implemented through collaboration among the NHSO (service payer), the Pharmacy Council (professional standards oversight), and community pharmacies (service providers). However, the programme lacks a comprehensive monitoring and evaluation framework. Current assessments primarily focus on service volume and reimbursement data, which often fail to capture essential aspects such as service quality, equity, and health outcomes. Moreover, no standardised indicators or precise governance mechanisms are in place. This gap limits the availability of actionable information needed for effective oversight and policy refinement.

While CI care services delivered through community pharmacies have expanded access to primary care, the system still lacks a clear and comprehensive framework for monitoring and evaluation. Establishing standardised indicators and strengthening oversight are essential steps to ensure continuous service improvement and long-term sustainability.

Colorectal cancer (CRC) remains a significant global health burden, with early detection playing a critical role in reducing morbidity and mortality. This study systematically reviews the cost-effectiveness of colonoscopy as a primary screening strategy to inform healthcare decision-making and resource allocation. This study aimed to evaluate the cost-effectiveness of colonoscopy as a primary CRC screening strategy.

A systematic review was conducted using studies published from 2020 to 2024 across PubMed, Scopus, and ScienceDirect. Studies were selected based on PICOS criteria, focusing on adults at high risk for CRC, colonoscopy as an intervention, cost-effectiveness as the outcome, and economic evaluations as the study design. Quality was assessed using the Joanna Briggs Institute (JBI) checklist for economic evaluations. Incremental cost-effectiveness ratios (ICERs) were compared against willingness-to-pay (WTP) thresholds.

Out of 2,602 identified records, 11 studies met the inclusion criteria. Most studies were from high-income countries and employed lifetime Markov or microsimulation models. Colonoscopy, performed every 10 years, generally showed greater effectiveness in reducing CRC incidence and mortality compared to no screening and other tests. It was cost-effective or cost-saving in the majority of studies, particularly when compared to no screening at all. However, in a few cases, colonoscopy was deemed not cost-effective relative to annual fecal immunochemical testing (FIT) due to model assumptions or differences in test sensitivity/specificity. Variability in adherence rates and healthcare system capacities impacted outcomes.

Colonoscopy, particularly when performed every 10 years, is typically a cost-effective or cost-saving strategy for CRC screening. Its superiority in reducing CRC incidence and mortality supports its continued use. Nevertheless, differences in modelling, healthcare context, and real-world adherence rates necessitate careful consideration when generalising findings. Further studies with sensitivity analyses and diverse population models are recommended.

Workforce maldistribution in Malaysia's healthcare sector, particularly between West and East Malaysia, remains a persistent challenge, with implications for equitable access to pharmacy services. This study examines systemic and contextual factors influencing pharmacists’ deployment and retention in underserved regions, integrating a first-hand account of relocation from a hospital in Kuala Lumpur to Sabah with evidence from national policy and literature.

A reflective case study approach was employed, combining personal field experience with a narrative review of literature on healthcare workforce distribution in Malaysia and comparable middle-income countries. Sources included Ministry of Health (MOH) policy documents, parliamentary reports, and peer-reviewed publications indexed in PubMed and Scopus. Thematic analysis was guided by a health systems framework encompassing governance, financing, human resources, service delivery, and information systems.

Current deployment strategies, while aligned with equitable access principles, often lack contextual adaptation to East Malaysia's unique geographical, infrastructural, and sociocultural realities. Observations and literature indicate that resource constraints such as limited pharmaceutical supply chain resilience, uneven health facility infrastructure, and restricted professional development exacerbate attrition risks. A combination of financial and non-financial incentives, career progression opportunities, family support mechanisms, and community integration has a significant impact on employee retention. The Sabah posting also demonstrated the operational importance of pharmacist-led logistics in ensuring medical readiness in rural healthcare contexts. Digital health tools, decentralised decision-making, and strengthened multidisciplinary collaboration emerged as critical enablers for improving service delivery and job satisfaction in rural postings.

Improving pharmacist retention in East Malaysia requires a context-sensitive, data-driven approach that translates national policy intent into locally responsive strategies. Priority measures include targeted incentive schemes, sustained investment in digital and logistical infrastructure, continuous professional development, and empowering local health facility managers in workforce planning and management. This synthesis of experiential insights and literature evidence highlights the need for a people-centric, resilient workforce policy to bridge the healthcare access gap between West and East Malaysia.

Non-adherence to antiretroviral therapy (ART) remains a significant barrier in HIV management, often driven by stigma, psychosocial stressors, and mental health conditions. Suboptimal adherence increases the risk of virological failure, drug resistance, and healthcare costs. The Motivational, Informative, and Nurturing Development (MIND) Module was developed as a structured psychosocial and educational intervention to enhance adherence among people living with HIV (PLHIV). This study aimed to evaluate the validity, reliability, and usability of the module, and to pilot-test its effectiveness among non-adherent patients.

The study was conducted between April and August 2025 at a healthcare clinic in Lembah Pantai, Kuala Lumpur. Six HIV experts performed content and face validation of the module. Reliability testing (Cronbach's Alpha) was conducted on the MIND Module, involving 30 healthcare providers, to establish internal consistency and usability. Pilot testing was carried out with PLHIV who had defaulted or were non-adherent to ART, identified through pill counts or Malaysian Medication Adherence Assessment Tool (MyMAAT) scores indicating moderate-to-low adherence, with a history of anxiety or depression. Pre-test assessments were conducted prior to module exposure, followed by post-test assessments after completion to evaluate effectiveness.

The MIND Module demonstrated strong content and face validity. Reliability testing confirmed excellent internal consistency (Cronbach's Alpha = 0.978). In the pilot study (n = 50), mean pre-test knowledge and adherence scores were 2.1 ± 0.8, increasing significantly to 8.0 ± 1.2 post-test (p < 0.001), reflecting nearly a fourfold improvement. Patient-reported outcomes supported these findings: 46 of 50 participants (92%) reported higher satisfaction with counselling, 44 of 50 (88%) noted an improved ability to manage stigma and emotions, and 45 of 50 (90%) expressed greater confidence in continuing ART. Healthcare providers endorsed the module's practicality and suitability for routine use. These results indicate that the MIND Module effectively improved knowledge, adherence behaviours, and psychosocial resilience.

The MIND Module is a validated, reliable, and practical intervention to enhance ART adherence while addressing the psychosocial needs of PLHIV. Beyond clinical benefits, it has the potential to be integrated into HIV care programmes and inform national strategies for improving long-term treatment outcomes in Malaysia and comparable healthcare settings.

Antimicrobial resistance (AMR) remains a critical global health concern, with localised educational initiatives needed to strengthen antimicrobial stewardship (AMS). In academic institutions, AMS-focused interventions can play an important role in shaping awareness and responsible antimicrobial use. This study aimed to evaluate the knowledge, attitudes, practices, and perceptions (KAPP) of first-year students and employees in a local university in the Philippines, and to determine the effectiveness of a structured AMS educational intervention.

A quasi-intervention design was conducted involving 144 first-year students and 44 employees. Participants completed a pre-test, attended a lecture delivered by a hospital pharmacist, accessed an educational website, and completed a post-test and evaluation form. Quantitative data were analysed using descriptive statistics, paired t-tests, and subgroup analysis by demographics, while qualitative feedback was thematically analysed. Instrument reliability was confirmed using KR-21 and Cronbach's alpha.

Baseline scores indicated comparable levels of AMS knowledge between students and employees, with employees scoring slightly higher in practice and perception. Following the intervention, both groups demonstrated significant improvement across all KAPP domains, confirming the effectiveness of the intervention. Students demonstrated greater gains in knowledge, while employees retained higher scores in practice and perception, reflecting the influence of real-life experience. Statistically significant differences were also observed across several demographic factors, including sex, certain colleges, age groups, educational attainment, and income, though some subgroups showed no significant change. These findings highlight both the broad impact of AMS education and the nuanced ways it interacts with prior knowledge, lived experience, and socioeconomic context. Feedback on the intervention was highly favourable, with participants emphasising the clarity, relevance, and effectiveness of both the seminar and the website.

The structured AMS educational intervention successfully improved KAPP scores among both students and employees, validating its utility in strengthening AMS awareness in academic settings. Despite limitations such as small subgroup sizes and variability in responsiveness, the study demonstrates that targeted, accessible education can enhance knowledge, shift attitudes, and reinforce stewardship practices. The integration of AMS programmes within universities represents a vital step in addressing AMR by shaping both immediate awareness and long-term behavioural change.

Hypereosinophilic syndrome (HES) is a rare condition that requires accurate diagnosis and targeted therapy. Fluorescence in situ hybridisation (FISH) and reverse transcription polymerase chain reaction (RT–PCR) are tools for detecting the FIP1L1-PDGFRA fusion gene and guiding imatinib treatment. This study evaluated the cost-utility of FISH and RT–PCR compared with no testing for HES management in Thailand from a societal perspective.

A combined decision tree and Markov model simulated gene testing and treatment pathways over a lifetime horizon, starting at age 18 with a 6-month cycle length. Health states included flare/worsening, remission, and death. Three strategies were compared: no testing, FISH, and RT–PCR. Patients in the no-test arm received glucocorticoids without genetic confirmation. In the FISH and RT–PCR arms, patients underwent one-time gene testing followed by glucocorticoids or imatinib depending on results. Costs and outcomes were measured in Thai Baht and quality-adjusted life years (QALYs). Probabilistic sensitivity analysis (PSA) was conducted, and cost-effectiveness acceptability curves (CEACs) were generated using willingness-to-pay thresholds of 0–600,000 Baht/QALY.

Both FISH and RT–PCR were dominant, providing greater health benefits at lower costs compared with no testing. The ICERs were –22,417 and –23,140 Baht/QALY for FISH and RT–PCR, respectively. PSA confirmed result robustness and showed that RT–PCR had a higher probability of being cost-effective (87%) than FISH (13%) across willingness-to-pay thresholds.

FISH and RT–PCR are cost-saving strategies for detecting the FIP1L1-PDGFRA fusion gene and guiding imatinib therapy in HES, with RT–PCR being the more favourable option. Policymakers may consider including these tests in benefit packages. Further research on long-term outcomes is warranted to refine future economic evaluations.

Clinical pharmacy services have gained increasing recognition for their contribution to improving therapeutic outcomes and patient safety. However, inconsistent policy support has limited their full integration into patient-centered care models. This study aimed to examine how policy reforms could strengthen the role of clinical pharmacists in enhancing therapeutic outcomes and ensuring medication safety, including aspects of drug pricing, health financing, and their implications for patient access and financial risk. In this context, policy reform referred to the development or modification of regulations, funding mechanisms, and institutional frameworks that enabled the integration, expansion, and sustainability of pharmacist-led clinical services within national healthcare systems.

A comprehensive literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. The search covered publications from 2010 to 2024. It used keywords such as ‘clinical pharmacy,’ ‘policy reform,’ ‘pharmacist-led services,’ ‘health financing,’ and ‘medication safety.’ Articles were included if they discussed policy frameworks or evaluated clinical pharmacy services in relation to regulatory or financial mechanisms. Studies were excluded if they focused solely on pharmacology without policy implications or lacked accessible full texts.

A total of 32 studies were reviewed. Pharmacist-led medication reviews were reported in 11 studies, therapeutic monitoring in 9 studies, wellness or follow-up services in 6 studies, and mixed interventions in 6 studies. Geographically, eight studies originated from China, six from Indonesia, five from Egypt, and the remainder from other health systems in the Asia-Pacific and Middle East regions. Medication review interventions were associated with reductions in drug-related problems ranging from 18% to 45%. Therapeutic monitoring studies reported target achievement or compliance rates ranging from 60% to 85%. Wellness and follow-up services showed improved adherence and reduced hospitalisation risks. Across the literature, strong regulatory backing, institutional commitment, interdisciplinary collaboration, and competency-based training were identified as essential enablers. Outcome-based and value-based reimbursement models were also identified as mechanisms that enhanced service sustainability and economic viability.

Policy-driven approaches were essential in advancing clinical pharmacy services toward a more patient-centered, sustainable, and high-performing healthcare system. Without supportive regulations, investment in workforce development, and reimbursement mechanisms aligned with clinical outcomes, long-term progress in clinical pharmacy was likely to remain constrained.

Vitamin D is essential for child growth and development, and inadequate maternal knowledge about its role may contribute to stunting in children. This study evaluated the effectiveness of nutrition education in enhancing maternal knowledge of vitamin D and its role in preventing stunting, employing a pre- and post-test design.

A quantitative pre–post study was conducted among 50 pregnant women in an urban area of Indonesia. Knowledge levels were measured using structured questionnaires administered before and after a short educational session. Data were analysed descriptively to assess changes in scores.

Stunting remains a major global health problem, affecting over 20% of children worldwide, particularly in low- and middle-income countries. Maternal vitamin D status plays a crucial role in fetal bone growth, immunity, and neurodevelopment; however, awareness among expectant mothers is often limited. In this study, the mean pre-test score was 55%, reflecting insufficient knowledge about vitamin D. Following the intervention, post-test scores rose to 84%, representing a 29% increase. The most significant improvement was observed in understanding the link between vitamin D and healthy pregnancy outcomes. These results align with international evidence that maternal nutrition education can address critical gaps in micronutrient awareness and positively influence dietary practices. The findings highlight that even simple, low-cost educational strategies can be effective in urban contexts where environmental and lifestyle factors may limit natural vitamin D synthesis. Strengthening maternal knowledge through targeted education contributes not only to improved pregnancy outcomes but also to broader public health goals of reducing childhood stunting.

Nutrition education significantly improved maternal knowledge of vitamin D and its role in stunting prevention. The marked improvement from pre- to post-test demonstrates the value of structured interventions for expectant mothers. Scaling up such programmes within routine maternal health services could represent a cost-effective and sustainable strategy to empower women, improve child health, and accelerate progress toward global stunting reduction targets.

This study aimed to isolate and identify Staphylococcus aureus (S. aureus) from the nasal cavities of relatively healthy university students residing in dormitories, assess their antimicrobial susceptibility profiles, and investigate the presence of key antibiotic resistance genes, particularly mecA.

A cross-sectional analytic study was conducted between February and May 2024. Nasal swab specimens (n = 100) were aseptically collected from students in university dormitories. Standard microbiological procedures were employed for the isolation and identification of S. aureus, including culture on selective media and biochemical tests. Antibiotic susceptibility testing was performed using the disc diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Molecular analysis through Polymerase Chain Reaction (PCR) was used to detect the presence of mecA, mecC, VanA, VanB, and select virulence-associated genes.

Among the 100 nasal swab samples, 42% demonstrated bacterial growth, with 26 isolates confirmed as S. aureus. The antibiotic resistance profile showed alarmingly high resistance rates to oxacillin (100%), penicillin (96.2%), ampicillin (69.2%), and gentamicin (53.8%). Moderate to lower levels of resistance were observed for ciprofloxacin (42.3%), azithromycin (26.9%), tetracycline (15.4%), clindamycin (11.5%), and chloramphenicol (11.5%). Notably, the mecA gene – an indicator of methicillin resistance – was detected in 6 out of 26 isolates (23%), with a slightly higher prevalence among female participants. No mecC, VanA, or VanB genes were detected, suggesting the absence of vancomycin resistance and alternate methicillin resistance mechanisms. The detection of multidrug-resistant (MDR) S. aureus strains in asymptomatic carriers raises concern regarding the silent spread of resistant organisms within the community and highlights the potential role of healthy individuals as reservoirs for methicillin-resistant S. aureus (MRSA).

The findings underscore a substantial carriage rate of S. aureus, including MRSA strains, among healthy university students, accompanied by multidrug resistance to several frontline antibiotics. Routine screening, molecular surveillance, and targeted interventions are crucial for early detection, containment of community-associated MRSA, and reinforcement of antibiotic stewardship practices to mitigate the risk of widespread antimicrobial resistance.

The COVID-19 pandemic led to increased global interest in complementary and alternative medicine (CAM), particularly herbal remedies. In Qatar, where traditional medicine is deeply culturally embedded, there is limited data on the use of herbal medicine during the COVID-19 pandemic. This study examined the prevalence, motivations, usage patterns, and sociodemographic factors influencing the use of herbal medicine among COVID-19 patients in Qatar.

A cross-sectional online survey was conducted among adults who had previously been diagnosed with COVID-19 and were registered at Primary Health Care Corporation (PHCC) clinics in Qatar. A total of 879 responses were collected from 10,000 SMS invitations. The survey included questions on the use of herbal medicine, motivations, perceived benefits, and sociodemographic variables. Logistic regression was used to identify predictors of herbal medicine use.

Out of 879 respondents, 424 (51%) reported using herbal medicine during their COVID-19 illness. Female sex (OR = 1.96; 95% CI: 1.33–2.87; p = 0.001) and Qatari nationality (OR = 1.78; 95% CI: 1.14–2.78; p = 0.013) were significantly associated with the use of herbal medicine. The most commonly used herbs were ginger (48.3%), turmeric (30.9%), and green tea (21.5%). Herbal medicines were primarily self-prescribed or recommended by family and friends. Motivations included family tradition (41.3%), belief in natural remedies (35.1%), and health improvement (31.8%). Most users (86.3%) reported symptomatic relief, particularly for sore throats and coughs.

Herbal medicine was widely used among COVID-19 patients in Qatar, driven by cultural beliefs and perceived benefits. The findings highlight the need for culturally informed public health messaging and improved healthcare provider engagement regarding CAM use during pandemics.

People living with Human Immunodeficiency Virus (PLW-HIV) on Antiretroviral therapy (ART) diagnosed with Cancer and on Anti-Cancer Therapy (ACT) are at higher risk for Drug–Drug Interactions (DDIs). The objective of our study is to assess the Potential and all possible DDIs in HIV and Cancer patients.

This study was conducted in a tertiary care teaching hospital in South India. The DDIs between [ART and ACT (Group (Gr)1)], [ACT with Concomitant Medication (Con-Meds) (Gr2)], [ART with Con-Meds (Gr3)] were assessed for pattern, severity of DDIs using Micromedex (MM), Epocrates (EC), University of Liverpool (ULP) Database

A total of N = 280 patients were enrolled, with 40 (14.3%), 120, and 120 (42.9%) patients enrolled in Gr1, Gr2, and Gr3, respectively. A total of [n = 24] DDIs were reported in MC in Gr1, of which [n = 23] (95.8%) DDIs were ‘Major’: Atazanavir with Cyclophosphamide, Nevirapine with Doxorubicin. ‘Moderate’ DDIs between Ritonavir with Tenofovir [n = 1] (4.2%). In EC, {n = 66} DDIs were reported, 52(78.8%) were ‘Avoid/Use alternative’, 13(19.7%) ‘Monitor/ Modify’, 1(1.5%) ‘Caution advised’. In ULP, {n = 46} 42(91.3%) of DDIs were ‘Amber’ followed by ‘Yellow’ 4 (8.7%). In Gr 2, in MM, a total of [n = 466] DDIs were reported, with [n = 363] (77.9%) classified as ‘Major DDIs’. Majority of Major DDIs higher with 20(4.1%) Dexamethasone with Paclitaxel, 26(5.6%) Doxorubicin with Dexamethasone, 21(4.5%) Paclitaxel with Ranitidine, 16(3.4%) Tapentadol with Palonosetron. [n = 96] (20.6%) ‘Moderate DDIs’ Dexamethasone with Aprepitant. In Gr 3, total of [n = 147] DDIs reported, MC, ‘[n = 134(91.1%)] Major’, ‘[n = 9(6.1%)] Moderate’, ‘[n = 2(1.4%)] Minor’, ‘[n = 2(1.4%)] Contraindicated’ DDIs. Major DDIs were Dolutegravir with Calcium 11(7.5%), Tenofovir with Aspirin 8(5.4%), Dolutegravir with Magnesium citrate 6(4.1%). In EC Gr 3, a total of [n = 325] DDIs were reported ‘contraindicated [n = 2] (0.6%)’’, [n = 78(24%) Avoid/ Use alternative], [n = 140] (43.1%) Monitor/ Modify, [n = 105] (32.3%). Caution advised DDIs. Out of which 45 (13.9%) DDIs were found in Lamivudine with Dolutegravir, followed by Tenofovir with trimethoprim, 26(8%). A total of [n = 272] DDIs were reported as per ULP in Gr 3, i.e. [n = 174] (63.9%) Amber, [n = 10] (3.7%) Red, n = 88 (32.3%) Yellow severity.

Our findings will help clinicians to focus on preventing and minimising all possible DDIs in HIV and cancer patients.

Recognisable benefits significantly influence the use of insulin pumps among children. An in-depth understanding of the mothers’ perspectives on insulin pump use can provide useful information on various challenges and benefits of this new revolutionary technology in type 1 diabetes management. Therefore, this study aimed to explore mothers’ experiences and perspectives on the perceived benefits of insulin pump therapy among their children

This qualitative exploratory research involved in-depth interviews of mothers in the United Arab Emirates whose children had type 1 diabetes and used an insulin pump. Eight mothers with children under the age of 12 years were enrolled using purposive sampling and interviewed using a validated interview guide during March 2025. Thematic analysis was performed.

Four children were recent users of the insulin pump (<1 year) and the themes generated were mothers’ knowledge and perception of insulin pump use, the clinical, psychological, and social impact of insulin pump use, and challenges faced and mothers’ recommendations on insulin pump use. Among the themes identified, the most prominent was the perceived benefit and impact of insulin pump use on children's clinical outcomes, psychological well-being, and social life. The use of insulin pumps had a largely positive impact on both diabetic children and their mothers. Mothers reported reduced stress, improved glycemic control, and greater flexibility in daily life. Improved HbA1c levels and easier adherence due to the pump's portability and fewer injections were noted, and the need for hospital visits also decreased significantly. Initially, children were anxious about wearing the pump, but over time, they adapted, showed an improvement in emotional well-being, and greater social engagement, especially in school settings. Mental health also improved among mothers after the introduction of insulin pumps among their children. One mother described it as ‘my right hand.’ Socially, the pump caused minimal disruption, with manageable restrictions during travel or sports. Many mothers appreciated the support received from the UAE government and charitable organisations, which eased access to pump therapy.

Mothers perceived that insulin pump use significantly enhanced both the clinical outcomes and quality of life of them and their children.

Community pharmacists (CPs) have a pivotal role in providing pre-travel consultations, particularly for prospective Hajj and Umrah pilgrims. However, validated instruments to systematically evaluate their practices and the beliefs that influence service provision are currently lacking. This study aimed to develop and validate a theory-driven survey instrument designed to assess the practices and beliefs of CPs related to their involvement in pre-travel consultations for prospective Hajj and Umrah pilgrims.

A five-step methodological approach was adopted: (1) generating items through qualitative data analysis and literature review; (2) conducting content validation via an expert panel review; (3) performing cognitive interviews with CPs; (4) assessing test-retest reliability; and (5) evaluating feasibility. Item development, particularly for belief-related constructs, was guided by the Theoretical Domains Framework (TDF).

The initial instrument consisted of 49 items: 7 related to practices and 42 to beliefs. Following content validation, two belief items were removed, and 40 items were refined. Cognitive interviews prompted additional modifications to four items, enhancing clarity and contextual relevance. Reliability testing conducted with 30 CPs showed Cohen's kappa values ranging from 0.583 to 1.00 for binary practice items, and intraclass correlation coefficients (ICC) ranging from 0.530 to 0.910 for belief items, indicating moderate to excellent temporal stability. Feasibility testing with 30 CPs confirmed that the instrument was straightforward and user-friendly in both paper-based and online formats. The final instrument comprises 47 items: 7 addressing practices and 40 examining beliefs aligned with the domains of the TDF.

This validated, theory-based instrument provides a comprehensive tool for assessing the involvement of CPs in pre-travel consultations for prospective Hajj and Umrah pilgrims. It facilitates research, informs training programmes, supports service improvement, and has potential for adaptation in broader travel-health service contexts.

This study assessed the information-gathering and counselling practices of community pharmacists in managing minor ailments, as well as the quality of counselling areas in selected independent drugstores in Taguig, Makati, and Pateros, Philippines.

Thirty community pharmacists participated. Data were collected through a validated, researcher-made questionnaire (Cronbach's α = 0.89) comprising six sections: demographic profile, common minor ailments, medicines used, information-gathering (11 items), counselling practices (9 items), and counselling area assessment (8 items), all rated using a 5-point Likert scale. Questionnaires were distributed and retrieved in person. Correlation analyses were performed using JAMOVI. Qualitative interviews were conducted with six pharmacists (the highest and lowest scorers per city) to explore their perspectives on enablers and challenges. Data saturation was observed, and thematic analysis was applied.

Quantitative findings showed that information-gathering practices were ‘very often’ in Makati (mean 3.6±3.2), ‘sometimes’ in Taguig (3.2±2.8), and ‘sometimes’ in Pateros (2.9±2.8). Counselling practices were most frequent in Makati (4.1±3.6, ‘very often’), moderate in Taguig (3.7±3.2, ‘very often’), and lowest in Pateros (2.4±3.7, ‘rarely’). The quality of counselling areas was rated ‘poor’ in Makati (2.2±2.6), ‘poor’ in Taguig (2.5±2.4), and ‘very poor’ in Pateros (1.2±1.5). No statistically significant differences were observed across the three cities. Thematic analysis highlighted pharmacists’ roles in promoting self-care, accessibility, and patient empowerment, alongside challenges such as communication barriers, lack of standardised guidelines, and inadequate infrastructure.

Overall, while pharmacists actively provide counselling, the lack of appropriate counselling environments and practice inconsistencies remain major barriers. An action plan was developed to strengthen minor ailment management through structured information gathering tools, counselling aids, and improvements in physical or alternative counselling spaces. These findings emphasise the importance of training, infrastructural support, and standardised practices to optimise community pharmacy services and patient outcomes.

Falls are a significant public health concern among ageing populations, often leading to serious injury and loss of independence. Pharmacists, as accessible healthcare providers, can play a pivotal role in fall risk screening and education. This study aimed to evaluate the effectiveness of a pharmacist-led community service programme, guided by the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) framework, in screening for fall risk and enhancing awareness and perceived knowledge among middle-aged and older adults.

A cross-sectional educational intervention was conducted as part of a community service initiative at a senior activity centre in Puncak Alam, Malaysia. Participants aged ≥50 years completed a pre-intervention survey that included the STEADI 3KQ: (i) Have you fallen in the past year? (ii) Do you feel unsteady when standing or walking? Moreover, (iii) Do you worry about falling? This was followed by a pharmacist-led educational programme delivered through five interactive learning stations: (1) complications and risk factors for falls, (2) physical activity and orthostatic hypotension, (3) bone health and nutrition, (4) medications that increase fall risk, and (5) preventive strategies such as eye and foot care, proper footwear, and home safety modifications. Each station combined short lectures, discussions, and visual aids tailored to older adults. A post-intervention survey was used to assess immediate changes in participants’ perceived knowledge. Descriptive statistics, Wilcoxon signed-rank tests, and chi-square analyses were employed.

A total of 82 participants were enrolled, with 69.5% classified as being at risk for falls based on the STEADI 3KQ. Fall-related worry was significantly associated with age, marital status, employment status, bone health, and the use of complementary medicine. Among those at risk, 10.5% were using fall-risk-increasing drugs (FRIDs). Post-intervention analysis showed significant improvements in perceived knowledge across all educational domains (p < 0.001), with the most substantial gain noted in awareness of FRIDs.

The pharmacist-led community service intervention effectively screened for fall risk and enhanced participants’ understanding of fall prevention. Community-based educational programmes utilising the STEADI-Rx framework are feasible and valuable for promoting awareness of fall risk among middle-aged and older populations.

In Thailand, the Common Illness (CI) programme was introduced to expand access to primary healthcare by enabling community pharmacists to manage minor ailments, thereby reducing the burden on hospitals while improving timely care and patient satisfaction. Therefore, this study was designed to investigate the outcomes of the Common Illness (CI) service delivered by community pharmacists and to explore patients’ perceptions of the service.

A descriptive prospective study was undertaken to investigate patients’ outcomes from the community pharmacist-delivered CI service. The Pharmacy Council of Thailand mandated training for community pharmacists in CI service. In collaboration with the National Health Security Office (NHSO) of Thailand, the Pharmacy Council specified 16 common illnesses, categorised by symptoms, for which pharmacists are authorised to dispense medications. The medications used in CI services are regulated by the official guidelines for providing CI services. Pharmacists followed up with patients on days 3 and 7 to assess clinical outcomes (cured, improved, unchanged, or worse). Perceptions of the CI service were evaluated through a cross-sectional survey using the street survey method. Descriptive analysis was applied in this study.

A descriptive prospective study was conducted with 151 patients. Of these, 68.9% were reported as cured and 27.8% as improved on day 3. By day 7, 90.7% were cured and 7.3% showed improvement. The three most frequently reported symptoms were cough (20.4%), sore throat (14.7%), and both fever (13.7%) and stomachache (13.7%). In a cross-sectional survey of 300 respondents, 42% reported being aware of the community pharmacist-delivered CI service. The three most recognised symptoms among the 16-CI symptoms were headache (8.4%), fever (8.1%), cough (8.1%), and diarrhea (7.5%). The clinical outcomes of patients included in the CI service demonstrated full recovery by day 7, indicating that community pharmacists played a significant role in improving patient outcomes. However, findings from the perception survey revealed limited public awareness of the CI service. To address this issue, advertising strategies should be implemented to enhance awareness of the programme and improve access to pharmacy services within community settings.

Community pharmacists played a key role in improving patient outcomes through the CI service. Public awareness campaigns are recommended to enhance understanding and promote greater utilisation of the service.

COVID-19 has been associated with multiple organ complications, including the kidneys, leading to an increased risk of chronic kidney disease (CKD) among hospitalised patients. Understanding the clinical and treatment-related factors contributing to CKD after COVID-19 infection is crucial for improving patient outcomes. To evaluate the factors that may contribute to the development of chronic kidney disease following COVID-19 infection among hospitalised patients in two private hospitals in Jakarta, Indonesia.

This is a retrospective cohort study between March 2020 and September 2021. Patient selection was conducted with convenience sampling. All patients (n = 378) meeting the inclusion criteria during the study period were enrolled. Various sociodemographic, laboratory test, and diagnostic parameters were measured to determine their correlation with the outcome of COVID-19 infection. In this study, all pre-vaccinated patients with COVID-19 had no history of chronic kidney disease (CKD) prior to admission to the hospital. The descriptive data were analysed using the Mann–Whitney, Wilcoxon, chi-squared, Cox regression, and Kaplan–Meier tests with SPSS software version 26.0. A significant correlation was indicated by a p-value < 0.05.

Overall, significant correlations were established between the clinical outcome and the CKD status (p = 0.001). Interestingly, there was a significant correlation between serum creatinine level, glomerular filtration rate (GFR), and CKD (p < 0.0001). Oxygen saturation (p = 0.03), admission to the intensive care unit (ICU) (p < 0.0001), and sepsis (p = 0.005) were factors that were significantly correlated with CKD status. Additionally, the type of antibiotic agent used was significantly correlated with CKD (p = 0.011). While 82.1% of patients with CKD survived, the survival rate worsened if the patients had complications from hyperuricemia (p = 0.010). The patients who received levofloxacin and ceftriaxone had the highest (100%) survival rate after approximately 50 days of treatment. The patients who received the antiviral agent combination of isoprinosine, oseltamivir, and ivermectin fared better (100%) compared to those who received isoprinosine and favipiravir (8%).

Factors, such as hyperuricemia and the antibiotic agent used, contributed to CKD following COVID-19 hospitalisation. Besides that, sepsis and hospitalisation status (ICU) impacted mortality among these patients, with both having equal mortality rates. Overall, patients with CKD should be carefully monitored to confer better protection against COVID-19 due to the higher mortality rate observed. Overall, patients who develop CKD following COVID-19 hospitalisation have a low survival rate.

Tuberculosis (TB) remains a global health threat, affecting over 10 million people and causing 1.3 million deaths annually. Beyond its clinical impact, TB significantly reduces patients’ quality of life (QoL), particularly in psychological, social, and economic domains. This impairment is even greater among those with drug-resistant TB (DR-TB), who face longer treatment, severe side effects, stigma, and limited support. However, research on QoL in DR-TB populations remains limited, highlighting a critical gap in patient-centered TB care. This study aims to analyse the relationship between sociodemographic and clinical characteristics and health-related quality of life (HRQoL) in patients with drug-resistant tuberculosis (DR-TB), using the EQ-5D-5L instrument.

A cross-sectional analytic study was conducted at Persahabatan National Respiratory Referral Hospital, Jakarta, involving 138 DR-TB patients recruited between February and April 2025. Data were collected through structured interviews. The EQ-5D-5L index and EQ visual analogue scale (EQ-VAS) were used to quantify HRQoL.

The results of the study show that the most common characteristics are age 26–59 years, male gender, highest level of education is high school (SMA), private sector employee, no history of smoking, married, TB treatment duration < 6 months, no history of illness, medications used include 6-month treatment and long-term treatment, most common medication side effects are gastrointestinal disorders, income below the minimum wage, no family dependents, social stigma supporting and encouraging patients, and health insurance coverage. The quality of life of TB patients had an EQ-5D-5L score of 0.773 ± 0.147 and an EQ-VAS score of 0.8 ± 0.149, with pain/discomfort being the most common issue at 51%. Statistical analysis showed no association between characteristics and the quality of life of TB patients.

The findings suggest that demographic and clinical characteristics may not be primary determinants of HRQoL in DR-TB patients. Instead, unmeasured factors such as psychological resilience, perceived stigma, adherence behaviour, and accessibility to comprehensive care services may play a more substantial role.

Venous thromboembolism (VTE) is a common cause and potentially life-threatening complication among patients with cancer. Patients with malignancy have a 4- to 7-fold higher risk of developing VTE compared to the general population. Statins, widely prescribed lipid-lowering agents, have attracted attention beyond their cardiovascular benefits due to their pleiotropic effects. Observational evidence and mechanistic studies suggest that statin use may be associated with a lower risk of VTE in this high-risk population. This study aimed to conduct a meta-analysis to determine the roles of statins in the primary prevention of VTE in patients with cancer.

We searched MEDLINE, Scopus, EMBASE, and Cochrane Central, without language restrictions. Databases were searched from their inception to May 2025. Eligible studies reported outcomes of primary VTE prevention in cancer patients receiving statin therapy. Both randomised controlled trials (RCTs) and non-randomised controlled trials (non-RCTs) were considered. Two authors independently screened studies, assessed methodological quality, and extracted data using a standardised form. Discrepancies between their assessments were resolved through discussion between reviewers and a combination of machine learning. Study quality was assessed using Cochrane RoB 2.0 or the Newcastle–Ottawa Scale (NOS). Pooled effect estimates were calculated as risk ratios (RR) using a random-effects model. This study was registered in PROSPERO (registration number: CRD420251088327).

A total of 5 observational studies involving 87,245 cancer patients who received statins. In the random-effects meta-analysis of observational studies, the use of statins was associated with a statistically significant reduction in VTE risk (RR = 0.82; 95% CI: 0.69–0.97; P = 0.024; I2 = 80%).

Statin therapy in patients with cancer was associated with a significant reduction in the risk of VTE. These findings are promising; randomised controlled trials are needed to confirm the role of statins in VTE prevention in this population.

Topical corticosteroid (TCS) phobia affects 31.0% to 95.7% of patients, particularly those requiring long-term use. This fear, often stemming from insufficient counselling by healthcare professionals, can result in inconsistent TCS application, ultimately compromising treatment efficacy. This study aimed to develop and evaluate the MEDERM chatbot (Monitoring and Educating Chatbot for Dermatologic Patients using Topical Corticosteroids) for providing information on TCS.

This study employed a research and development (R&D) design consisting of four stages: (1) identify the information framework based on a literature review, face validity assessments with three experts, and interview with 20 participants to gather user needs; (2) chatbot design and development; (3) assess participant knowledge with a 10-question pre- and post-test, and evaluate user testing and the System Usability Scale (SUS) among another 20 participants; and (4) chatbot refinement based on findings. The study was conducted from November 2024 to February 2025.

A total of 40 dermatologic patients receiving TCS treatment from a university hospital in Chiang Mai were included. The MEDERM chatbot provides information on dermatologic conditions and TCS, including indications, methods of use, actions to take if a dose is missed or overdosed, storage instructions, and potential adverse effects. Among the 20 participants interviewed, the most requested topics were non-pharmacologic treatments and TCS-related adverse effects. When the chatbot was tested with another group of 20 participants, users spent an average of 3.25 min interacting with it, and 25% of them revisited the chatbot after being discharged. Knowledge test scores showed significant improvement, increasing from a median of 4.50 (2.75–5.25) to 10 (9–10) (p = 0.0001).

The usability and satisfaction ratings were excellent, with a mean SUS score of 83.38 ± 9.94. In conclusion, the MEDERM chatbot demonstrated ease of use, perceived usefulness, and positive impacts on knowledge and satisfaction, highlighting its potential as an effective educational tool for TCS users.

Agricultural communities in Thailand often face challenges of poor soil and water quality, resulting in low-yielding and low-quality herbal crops with limited medicinal value. Addressing this issue requires collaborative efforts that integrate academic expertise, community participation, and organisational support. This study aims to demonstrate the outcomes of a collaborative initiative between academic institutions, non-profit organisations, and agricultural networks to strengthen community-based herbal agriculture and enhance the quality of herbal raw materials for health product development.

The Jumpasri Project (2023–2024) was led by Mahasarakham University's Faculty of Pharmacy, Faculty of Technology, and Walai Rukhavej Research Institute, in collaboration with local herbal enterprises, the Krisana Kraisintu Foundation, the Electricity Generating Authority of Thailand (EGAT), and the Mahasarakham Provincial Public Health Office. The project was implemented across three community enterprises and two schools. Key interventions included improving soil and water quality for herbal cultivation, refining propagation and processing practices to meet GAP standards, analysing active medicinal compounds, and developing prototype herbal products. Outcomes were evaluated in terms of product quality, community value creation, and sustainability of the herbal supply chain.

Knowledge exchange was fostered in cultivation, seed production, and processing, with emphasis on Andrographis paniculata (Fah Talai Jone) and Solanum trilobatum L. (Mavaeng). The project established three model communities, each specialising in seedling cultivation, seed production, or herbal processing. The processed A. paniculata achieved an andrographolide content of 6.009%, surpassing the 1% standard and increasing raw material value by 20–25%. A standardised analytical method for S. trilobatum was developed. Prototypes of A. paniculata capsules and S. trilobatum mouth spray were prepared and submitted for FDA registration. Pharmacists contributed expertise in compound analysis, formulation development, GMP compliance, and regulatory preparation.

The Jumpasri Project demonstrates how interdisciplinary collaboration can improve herbal quality, create value for local communities, and generate GMP-ready herbal medicine prototypes. This framework highlights the potential for academic service initiatives to strengthen sustainable agriculture, empower communities, and support the growth of Thailand's herbal health product sector.

The attitude of postgraduate pharmacy (PGP) students regarding the implications of artificial intelligence (AI) in research is crucial. The current research aimed to evaluate the attitudes and practices of PGP students regarding the implications of AI in research.

PGP students from different universities participated in an analytical survey to assess their attitudes and practices regarding AI in research. The current study was conducted over a period of two months (from May 1st to June 30th). Descriptive statistics were used to analyse quantitative data using SPSS 27.0. The clustering technique was employed to identify statistically significant differences in their responses between clusters using the Kruskal–Wallis H test and the Mann–Whitney U test.

A total of 126 PGP students responded to the survey. Most participants were in favour of the implications of AI in academic research (n = 123, 97.6%). However, less than half of participants agreed with the statement that ‘AI will replace the functions of researchers in general’ (n = 57, 45.23%). They had an opinion that there are ethical issues associated with the use of AI tools in research (n = 84, 66.66%). Although the majority (n = 87, 69%) reported no formal training in artificial intelligence, they (n = 102, 80.95%) planned to integrate artificial intelligence in future research. Gender was significantly associated with their response to the statement ‘I think AI will eventually take the place of statisticians and data analysts’ (U = 6.953, p = 0.031). The level of researcher (beginner, middle, senior) was significantly associated with different responses. I believe AI will eventually replace statisticians and data analysts (H = 9.966, p = 0.007). I also think it is ethically permissible to use AI tools for writing and research (H = 6.716, p = 0.035). I will learn to utilise artificial intelligence in my future research work (H = 6.382, p = 0.046).

The majority of PGP students have positive opinions regarding the implications of AI in research. There was broad agreement that AI would fundamentally assist researchers rather than replace them. Stakeholders and regulatory agencies should continuously pursue the integration of AI-based training in postgraduate studies to prepare PGP students for their future roles in healthcare.

This study evaluates the usability and clinical relevance of BioJ-Abx, an innovative project that aims to justify and provide antibiotic prescribing recommendations in primary care, based on the National Antibiotic Guidelines of Malaysia, incorporating artificial intelligence. Evaluating user acceptance of BioJ-Abx's practicality and its impact on workflow is crucial for the effective implementation of this technology.

A structured questionnaire, adapted from the Sarawak State Health Department's Satisfactory Survey on Innovation/Quality Assurance Project, was administered to all medical officers (n = 34) in health clinics within the Samarahan Division, Sarawak, Malaysia. The questionnaire consisted of 10 key indicators, each rated on a 5-point Likert scale. These indicators covered usability, work relevance, productivity, workforce efficiency, patient needs fulfilment, environmental friendliness, ergonomics, cost reduction, and overall benefits. Data were analysed using SPSS version 25, with higher scores indicating greater acceptability for each construct.

The results are presented as median (Interquartile Range). The 34 respondents reported high acceptance of BioJ-Abx, with at least a ‘4-Agree’ rating across all criteria, except for manpower reduction, which received a score of 3(3). The highest-rated attributes were project guideline clarity, 5(1) and relevance to respondents’ work, 5(1). Respondents agreed that the project improved work productivity 4(3), fulfilled patients’ needs 4(1), and brought benefits to patients 4(2). Additionally, respondents found the project user-friendly 4(2), environmentally friendly with green technology 4(1), fulfilling ergonomics criteria 4(2), and capable of reducing operational costs 4(2). BioJ-Abx successfully achieved its primary objectives of accessibility, environmental sustainability and patient-centeredness. High scores for guideline clarity, user-friendliness, and environmental integration suggest effective design in operational usability and sustainability, particularly vital in resource-constrained healthcare settings. The strong alignment with patient needs underscores the project's relevance to clinical outcomes and its potential contribution to antimicrobial stewardship initiatives. However, lower rating in manpower reduction indicate a disparity between perceived usability and actual workflow efficiencies. These findings imply that while BioJ-Abx is well-received in practice, further refinements in workflow integration, automation and training is necessary to maximise its operational impact.

BioJ-Abx has garnered positive acceptance. These findings offer valuable insights for refining implementation strategies to optimise both clinical and operational outcomes.

Clinical pharmacy services in low- and middle-income countries often lack standardised competency frameworks, limiting the quality and consistency of care. In Lao PDR, the absence of structured clinical pharmacy education and assessment tools has hindered workforce development and service integration. This study aims to develop a national clinical pharmacy competency framework and validate an Entrustable Professional Activities-based assessment tool (EPA-tool) to support clinical pharmacy education and practice in Lao PDR.

A two-stage mixed-methods study was conducted. Stage 1: Clinical pharmacy competencies were informed by American College of Clinical Pharmacy standards and survey data from hospital pharmacists (n = 158). A three-round modified Delphi method was then conducted with 36 experts, including representatives from the Ministry of Health (n = 10), hospitals (n = 9), and the Faculty of Pharmacy, University of Health Sciences (n = 17). Stage 2: An EPA-tool was derived from the framework and validated in a cross-sectional study involving 31 final-year pharmacy students. Competency assessments were conducted by three trained preceptors. Statistical analyses examined construct validity, reliability, and correlation with standard assessment tools.

Consensus was reached on a framework comprising six domains and 29 competency elements, refined to reflect local practice needs. The EPA-tool demonstrated strong construct validity and internal consistency (Cronbach's alpha = 0.982). Students scoring ≥85 on the EPA-tool had no significantly higher scores on a standard tool (86.00±1.02 vs. 85.54±0.46, p = 0.413). All E-tool items correlated positively with standard assessments (Pearson r > 0.2), and regression analysis showed moderate association (R2 = 0.285).

This study established a validated national competency framework and an EPA-based assessment tool for clinical pharmacy practice in Lao PDR. The tool demonstrated strong reliability but only moderate correlation with standard assessments. These findings highlight its potential to strengthen clinical pharmacy education and workforce development in Lao PDR, while also indicating the need for further refinement and testing before broader application.

Medication non-adherence in chronic diseases is a major contributor to poor health outcomes and rising healthcare costs. This study aimed to develop and evaluate the MediMinder Device and WebApp as a compliance aid for daily medication management. Unlike existing tools with limited functions, MediMinder integrates storage, reminders, tracking, and data analytics in one user-friendly platform. Grounded in human-centered design and behavioural theory, it provides a holistic intervention to support both patients and healthcare providers.

The MediMinder was developed using a prototyping methodology that included planning, Analysis, Design, testing, feedback, Iterative Refinement, and Final Implementation. Prototypes were iteratively improved by adding features to enhance performance. Using this approach, the device and web application were iteratively designed and refined with inputs from healthcare professionals, technical experts, and maintenance medication users. Evaluation questionnaires were based on ISO/IEC 25010 and ISO 9241-210 standards, focusing on technical performance, general acceptability, and perceived effectiveness.

Results showed that the MediMinder performed its role of tracking adherence events successfully and was accepted by patients and healthcare providers to a great degree. Its integrated web application for schedule customisation and adherence analytics added value by enabling monitoring of progress and patterns, supporting counselling and habit formation. Technical professionals gave an average score of 4.48 (Outstanding) and low dispersion (0.52 SD), confirming its human-centered design and technical performance, with excellent ratings and high consensus validating its reliability. Health Care Professionals (4.36±0.69) and Maintenance Medication Users (4.39±0.59) also rated it ‘Outstanding’, with low deviation indicating strong consensus of the device's general acceptability and effectiveness within each group, suggesting that the device successfully meets the expectations of both clinicians and patients.

The MediMinder system offers a practical, patient-centered approach to enhancing medication adherence, with the primary limitation being the need for a stable internet connection. Additionally, it may have limited compatibility with outdated browsers. Beyond reminders, it encourages patients to form sustainable medication-taking habits while equipping healthcare providers with real-time adherence data and analytics to inform clinical decisions. This study contributes to SDG 3 (Health) and SDG 9 (Industry, Innovation, and Infrastructure) by advancing digital adherence technology.

Asthma self-management is an effective method that empowers patients with asthma to control their condition and reduce its effects on their daily lives. This study aims to explore the knowledge, perceptions, barriers, and facilitators related to asthma self-management among asthma patients in Malaysia.

A qualitative study employing a phenomenological approach was conducted among asthma patients aged 18 years and above, with a diagnosis of asthma for at least three months, and without COPD or other lung diseases, using a semi-structured interview guide based on the literature and Corbin and Strauss's three self-management tasks of living with chronic illness. Based on data saturation, a total of 19 interviews were conducted. All interviews were audio-recorded and transcribed verbatim. A codebook was developed through an iterative process, and themes related to knowledge, perception, facilitators, and barriers were identified inductively. Each relevant theme was mapped deductively onto the three self-management tasks (medical, behavioural, and emotional management) described by Corbin and Strauss.

To improve interpretation, two overarching themes, (1) the impacts of asthma and (2) self-management of asthma, were constructed. Within ‘impact of asthma,’ one main theme, ‘living with asthma’ (subthemes: (a) asthma impact on physical and (b) psychological well-being) was identified. Under ‘self-management of asthma,’ four main themes were identified: (i) medical management (subthemes: (a) disease knowledge, (b) symptoms and (c) asthma attack management), (ii) behavioural management (subthemes: (a) lifestyle adaptation and (b) perceptions towards asthma management), (iii) emotional management (subthemes: (a) stress related to asthma management and (b) stress coping strategies), and (iv) factors influencing asthma self-management (subthemes: (a) barriers and (b) enablers). While asthma patients demonstrated a good understanding of the disease and self-management strategies, gaps remain in the area of self-monitoring. Patients’ perceived self-efficacy and beliefs towards traditional methods and asthma medication influenced self-management practices. Strengthening asthma education through structured counselling seminars can enhance patient awareness and engagement.

Healthcare professionals should provide each patient with asthma with an asthma action plan to facilitate effective asthma management. Furthermore, addressing barriers such as passive smoking, workplace difficulties, and social stigma is essential. Policymakers should prioritise initiatives to reduce these barriers and promote facilitators, thereby ensuring effective and sustainable asthma management.

Preparing pharmacy students for industrial practice requires strong knowledge, competencies, and professional attitudes. In the Philippines, the first three years of the BS Pharmacy programme serve as preparation for the internship year. Among the five practice areas, industrial pharmacy remains the least explored in local and international literature. This study assessed the preparedness of third-year BS Pharmacy students at National University–Manila for their industrial pharmacy internship, focusing on knowledge, competencies, and attitudes (KCA) and their relationship with demographic variables.

A descriptive, quantitative design was employed, utilising census sampling of eligible students (n = 95, 95% response rate). Data were gathered through a validated, self-made survey that underwent face and content validation and demonstrated acceptable internal consistency, as indicated by Cronbach's alpha. Knowledge was assessed through 16 yes/no items, while 20 4-Likert scale questions measured competencies and attitudes. Highly prepared was defined as having a mean knowledge score of greater than 75% and a mean competency and attitude score of greater than 3.00. The KCA domains were aligned with industrial pharmacy sub-areas, specifically manufacturing and regulatory affairs, based on the Philippine Practice Standards for Pharmacists (PhilPSP).

Students were generally highly prepared in manufacturing and regulatory domains, though some competencies were weakest. In manufacturing, these included product life cycle improvements, quality risk management, and involvement in validation and quality review. In regulatory affairs, low-rated skills were providing input on adverse event reporting, contributing to guidelines, addressing regulatory issues, and updating policies/SOPs. These areas are only briefly covered in select courses with limited assessment or training. Statistical analysis revealed no significant relationship between preparedness levels and demographic factors, including sex, age, academic status, or grades.

Students showed strong general preparedness but displayed gaps in specialised competencies. Targeted curriculum improvements, such as enhanced regulatory training, integration of policy writing, and stronger industry partnerships, are recommended to ensure graduates are practice-ready for the evolving demands of industrial pharmacy.

Adverse drug reactions (ADRs) pose a significant public health concern, and active consumer participation in reporting them is crucial for effective pharmacovigilance. The study aimed to determine the knowledge, attitudes, and practices of consumers regarding the direct reporting of adverse drug reactions to the FDA. Additionally, to identify key gaps and potential strategies for strengthening consumer engagement in pharmacovigilance.

A quantitative descriptive research design was employed, targeting six selected barangays in Sampaloc, Manila. Using Slovin's formula at a 5% margin of error and 95% confidence level, a total of 351 respondents were proportionally sampled from a household population of 2,886. Respondents were recruited using a purposive criteria with random sampling technique, ensuring balanced representation across the designated areas. Data were collected using a structured questionnaire that measured consumer knowledge, attitudes, and practices regarding ADR reporting.

The study revealed that consumers demonstrated limited knowledge about ADR reporting, with a score of 57.44%. There were several misconceptions, including the idea that only healthcare experts should report ADRs and that it is always predictable. Familiarity with official reporting channels, such as the FDA website and VigiMobile, was limited. On the other hand, the consumers showed a positive attitude towards ADR reporting, with a mean score of 3.51 on a 4-point scale, indicating their willingness to participate and acknowledgement of its significance for drug safety. However, a poor practice rate of 59.97% remained, as evidenced by low rates of actual reporting, incomplete submissions, and a tendency to rely exclusively on healthcare providers. These findings suggest that there are significant gaps in the public's understanding and participation in pharmacovigilance. Targeted interventions, including educational campaigns, peer engagement, and the promotion of user-friendly reporting tools, are recommended to improve consumer-driven ADR reporting and strengthen national drug safety systems.

The study offers a novel perspective on consumer-driven pharmacovigilance at the community level, a topic that is often overlooked in the current literature. The study highlights the importance of community-based education and local collaboration in empowering consumers to improve pharmacovigilance.

Thiamine has been investigated as an adjunctive therapy in sepsis and septic shock because of its critical role in mitochondrial energy metabolism; however, clinical evidence of its benefits remains inconsistent. This study aimed to evaluate the effects of thiamine on 14-day all-cause mortality and secondary clinical outcomes in patients with sepsis and septic shock.

A retrospective cohort study was conducted using medical records from a tertiary hospital between January 2018 and December 2022. Outcomes included 14-day mortality, renal replacement therapy (RRT) requirement, blood lactate reduction at 72 h, hospital length of stay (LOS), intensive care unit (ICU) LOS, and vasopressor duration.

Among 126 patients receiving thiamine, 14-day mortality was 13.64% (n = 9) compared with 11.67% (n = 7) in the non-thiamine group (p = 0.740). The mean reduction in 72-hour blood lactate was significantly greater with thiamine than without (20.56 ± 34.36 vs. 5.51 ± 24.09 mg/dL; p = 0.0012). RRT was required in 6.06% of thiamine patients versus 1.67% of controls (p = 0.206). Mean hospital LOS was 9.79 ± 7.80 days with thiamine and 8.50 ± 5.73 days without (p = 0.7633). ICU LOS was significantly longer in the thiamine group compared with controls (2.21 ± 5.82 vs. 0.07 ± 0.31 days; p = 0.0001). Vasopressor duration was also longer with thiamine (3.20 ± 4.17 vs. 0.92 ± 1.88 days; p<0.0001).

Thiamine supplementation in patients with sepsis and septic shock significantly reduced 72-hour lactate levels but did not improve 14-day mortality, RRT requirement, hospital LOS, ICU LOS, or vasopressor duration. These findings suggest potential metabolic benefits of thiamine without corresponding improvements in short-term survival or resource utilisation.

Despite their vital role in medication management, pharmacists remain underrepresented in Tuberculosis Directly Observed Treatment, Short-course (TB-DOTS) facilities in the Philippines. This study aimed to describe the organisational structure and workforce distribution in TB-DOTS facilities in Quezon City, determine the roles of pharmacists, and explore factors influencing their presence or absence by assessing the perspectives of eight (8) Management and Employees of TB-DOTS Facilities (METDF).

Semi-structured interviews were conducted with eight (8) METDF participants. Thematic analysis was used to analyse the qualitative data and extract key themes.

Nine themes emerged, highlighting pharmacists’ limited integration and systemic barriers, including a lack of permanent government work positions, a workforce shortage, and funding constraints. Findings reveal that doctors, nurses, and other staff frequently assume the responsibilities of the pharmacist due to the reality that pharmacists are not included as core healthcare workers in the Department of Health's National Tuberculosis Program (NTP) Manual of Procedures.

Despite the lack of formal inclusion, all METDF participants expressed strong support for the inclusion of pharmacists, citing that they have a valuable role in patient counselling, drug inventory management, pharmacovigilance, and improved treatment adherence. However, their integration remains inconsistent due to the absence of policy frameworks, inadequate funding, and limited government support. Updating the National Tuberculosis Control Program Manual, creating permanent work positions, allocating funding resources, and fostering collaboration between government and professional organisations are critical to fully leverage pharmacists’ potential in strengthening TB care and advancing national TB elimination goals.

This study evaluates the effectiveness of China's ‘List of Encouraged Pediatric Drugs for Research, Development and Application’ in addressing key challenges in pediatric drug development, including insufficient drug variety, dosage form shortages, and slow market access.

Using data from five List batches, we conducted a quantitative analysis based on therapeutic area (classified by WHO ATC system), dosage forms, and drug registration-to-market timelines. Data were collected from the NHC and CDE websites. Excel was used for statistical analysis of approval periods and formulation types.

A total of 152 drugs were included across five List batches, covering 15 therapeutic areas. Focus was placed on nervous system, oncology, cardiovascular, metabolic, and hematologic drugs (68.75%). Oral liquids (36%) and injections (32%) were the dominant dosage forms, meeting pediatric needs for precise dosing. However, timelines from List publication to registration acceptance were long and varied widely, with some exceeding 2,700 days. The average time from registration acceptance to market launch was 613 days. The List has helped direct R&D efforts, but pediatric drug availability remains limited, with persistent shortages of suitable formulations and low utilisation of approved products.

While the List policy has provided clearer R&D guidance and fostered innovation in pediatric formulations, its actual impact is constrained by delayed registration and approval processes and limited market output. To enhance policy effectiveness, improvements are needed in List selection mechanisms, regulatory efficiency, and targeted incentives to stimulate industry participation and accelerate pediatric drug development and accessibility.

This study aimed to examine and analyse the operational structure and processes of the narcotic and psychotropic substance (NPS) supply chain in Thailand. It focused on the stages of procurement, import authorisation, customs procedures, warehousing, and distribution. The goal was to identify key operational challenges, delays, and inefficiencies that could affect timely access to medicines, all while ensuring compliance with regulatory standards.

This qualitative research employed a two-process approach: (1) document analysis of the regulatory and operational guidelines governing the NPS supply chain in Thailand, and (2) semi-structured in-depth interviews with key stakeholders involved in the supply chain. Thematic analysis was used to identify and categorise the emerging operational challenges, delays, and procedural gaps at various stages of the supply chain.

The NPS supply chain in Thailand consists of five key stages: procurement, import authorisation, customs clearance, warehousing, and distribution. Although procurement has been digitised, it still takes up to 7 weeks due to the need for multiple levels of approval. Import authorisation involves several license checks, with each stage taking around three working days. Customs clearance is generally efficient, typically taking about one day; however, occasional inconsistencies in interpretation can occasionally lead to delays. The warehousing stage includes a 5- to 7-day inspection process, which is hindered by limited storage capacity and the absence of real-time tracking. Distribution encounters further delays due to repeated licensing requirements and manual paperwork. The primary challenges identified within this supply chain include procedural repetition, inadequate inter-agency coordination, and limited flexibility in responding to urgent medicine needs.

The study found that the supply chain for NPS in Thailand is a highly regulated, multi-stage system. It suffers from significant delays due to lengthy approval processes, complicated documentation requirements, and poor coordination among agencies. These issues lead to delays in procurement and distribution, which can hinder timely access to essential medicines. To enhance accessibility and security within the supply chain, it is essential to address these bottlenecks through improved inter-agency coordination, digital process enhancements, and regulatory simplification.

The rapid digital transformation in the pharmaceutical sector has created new opportunities to strengthen Good Distribution Practices (GDP) while also introducing challenges in implementation and emerging risks. Ensuring compliance and supply chain resilience requires a structured evaluation of how digital technologies are adopted and how they mitigate risks. This review aims to evaluate the implementation of digitalisation in Good Distribution Practices (GDP) by examining the 12 aspects of GDP outlined in BPOM Regulation No. 20/2025, with a focus on identifying key challenges and enabling factors. It also examines the role of digital technologies in mitigating major risks in pharmaceutical distribution – specifically cyber threats, system failures, and human error – through the application of IoT, blockchain, AI, predictive analytics, and digital QMS.

A systematic literature review was conducted following PRISMA guidelines. Peer-reviewed articles and industry reports published between 2019 and 2024 were retrieved from databases including PubMed, Scopus, and ScienceDirect. Search terms combined keywords and MeSH terms such as ‘digitalization,’ ‘Good Distribution Practices,’ ‘risk management,’ ‘IoT,’ and ‘pharmaceutical supply chain.’ Eligible studies focused on pharmaceutical distribution, addressed the implementation of digital tools, and discussed risk management. Exclusion criteria included non-pharmaceutical contexts, articles lacking digital focus, or non-empirical reports. Data were synthesised thematically to identify challenges, enablers, and digital strategies for risk mitigation.

The review identified two main themes. First, the implementation of digitalisation in GDP is influenced by challenges such as high capital investment, limited technical expertise, organisational resistance, and fragmented infrastructure, while enabling factors include leadership commitment, regulatory support, training, and cross-sector collaboration. Second, risk mitigation through digitalisation showed that blockchain enhances data security against cyber threats, IoT and predictive analytics reduce system failures through real-time monitoring, and digital QMS with automation minimises human error. These findings demonstrate that digital transformation not only supports regulatory compliance but also strengthens resilience and transparency across pharmaceutical distribution systems.

Digital transformation in pharmaceutical distribution requires alignment between strategic implementation and risk management. Key success factors include leadership commitment, supportive regulations, workforce training, and cross-sector collaboration. At the same time, digital technologies mitigate risks by strengthening data security against cyber threats, reducing system failures through predictive monitoring, and minimising human error with automation and digital QMS. Overall, adopting a risk-based digital approach enhances compliance with GDP and builds more resilient, transparent, and sustainable pharmaceutical distribution systems.

Earning a bachelor's degree in pharmacy in the Philippines does not ensure eligibility to practice, as passing the Pharmacists Licensure Examination (PhLE) is required. PhLE passing rates remain low, averaging 58.88% over the past decade, with first-time takers below 79% and repeaters under 45%. To support repeaters, the Philippine Association of Colleges of Pharmacy (PACOP) introduced the Pharmacy Refresher Programme in 2006 for candidates who failed the PhLE three times. This study evaluated the programme's impact on programme completers, lecturers, and schools (represented by Deans) from Batches 31 to 33.

A cross-sectional descriptive-comparative design was used. A researcher-developed survey, covering five domains (programme content, instructor effectiveness, learning outcomes, examination performance, and programme delivery), was validated (Validity Index = 1.00), pilot-tested (Cronbach's alpha = 0.915) with 10 respondents per group, and administered online. The data were analysed using both descriptive and inferential statistics.

Most completers (N = 64) were young (21–30 years old), female, and BS Pharmacy graduates from 2011 to 2020. Nearly half (n = 31) passed the PhLE on their first attempt after completing the programme. Lecturers (N = 11) were highly qualified, with many holding doctorates and 11–20 years of teaching experience. Schools (N = 7) were mainly accredited. The programme showed a substantial impact across all groups. Completers (89.43%, High Impact) valued relevant content, effective instructors, and exam readiness, but noted issues with time management, lecture variability, interactivity, and mental health support. Lecturers (86.74%, High Impact) praised structure and alignment but suggested hybrid delivery, standardised handouts, and more time for complex topics. Schools (78.64%, High Impact) affirmed exam alignment but cited weaker outcomes, limited communication with PACOP, and the need for more face-to-face sessions. No significant differences were observed in the perceptions of completers by demographics. Significant differences were observed between completers and schools in programme content (p = 0.005) and exam performance (p = .010), as well as among groups in content (H = 8.855, p = 0.014). A strategic plan recommends optimising duration, enhancing communication, expanding hybrid and regional delivery, standardising content, and integrating wellness support.

The Pharmacy Refresher Programme benefits completers and stakeholders. Improving communication, mental health support, instructional consistency, and adopting flexible hybrid delivery are recommended to strengthen effectiveness and sustainability.

Curcumin, a bioactive compound derived from Curcuma longa, has been widely investigated for its pharmacological properties, including anti-inflammatory, antioxidant, and antimicrobial activities. In recent years, attention has shifted toward its antibacterial potential, particularly in the context of rising antibiotic resistance. Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus (MRSA) are critical pathogens associated with severe infections, high morbidity, and mortality due to multidrug resistance. The objective of this systematic review is to evaluate the antibacterial activity of curcumin, with a focus on resistant pathogens such as S. aureus and MRSA, while highlighting mechanisms of action, efficacy across formulations, and therapeutic potential.

A systematic search of PubMed, Scopus, and Google Scholar was conducted for studies published between 2013 and 2024. Twenty-five studies were included, comprising in silico and in vitro designs. Data extraction focused on curcumin's antibacterial mechanisms, minimum inhibitory concentrations (MICs), synergistic effects with antibiotics, and performance of nanocurcumin formulations.

Curcumin demonstrated notable antibacterial activity, especially against Gram-positive bacteria. Reported MIC values ranged from 128.8 µg/ml to 293 µg/ml, depending on bacterial strain and formulation. Nanocurcumin consistently exhibited lower MIC values compared to conventional curcumin, indicating enhanced potency. Mechanisms of action included disruption of bacterial cell membranes, inhibition of essential enzymes, and induction of oxidative stress. Importantly, curcumin exhibited synergistic interactions with conventional antibiotics, significantly enhancing their efficacy against resistant strains. While curcumin's activity against Gram-negative bacteria such as Escherichia coli and Pseudomonas aeruginosa was relatively weaker, it demonstrated strong anti-biofilm effects, which are critical in managing chronic and device-associated infections. Despite these promising findings, curcumin's poor bioavailability remains a major limitation for clinical use.

Curcumin holds considerable promise as an adjunct antimicrobial agent, particularly against resistant Gram-positive pathogens and biofilm-related infections. Its broad-spectrum antibacterial activity and synergistic potential with existing antibiotics underscore its therapeutic relevance. However, addressing its limited bioavailability is essential, and nanoparticle-based delivery systems offer a viable strategy. Further preclinical and clinical research is warranted to establish curcumin's role in combating antibiotic resistance.

The future of pharmacy practice is on the verge of significant evolution in the coming years, driven by advancements in technology, changes in healthcare delivery models, and responses to ongoing challenges such as workforce shortages and rising drug costs. The objectives of this study are to analyse key trends that will influence the future of pharmacy practice and provide essential insights for pharmacists, policymakers, and stakeholders to adapt and innovate in an evolving landscape.

This review synthesises data from peer-reviewed publications published between 2020 and 2025, focusing on trends in technology, economics, policy, and clinical practice. Themes and sub-themes were also analysed.

The peer-reviewed publications and reports highlight several key trends, including the increased integration of artificial intelligence (AI), the expansion of pharmacists’ roles in primary care, and the management of high-cost medicines. These trends aim to enhance patient outcomes, improve efficiency, and address disparities in access to care. AI is expected to transform pharmacy operations and patient care, likely being used for tasks such as electronic health record (EHR) documentation, data analysis, and personalised treatment planning. There is also a pressing need to strengthen health systems, as this is crucial for any effective changes in the future. The research emphasises outcomes-based methodologies, with pharmacists playing essential roles in chronic disease management through telehealth and remote services. The focus on high-cost medications, including cell and gene therapies, is also increasing. The major themes and trends in the evolution of pharmacy arising from these developments include the integration of AI and technology, the availability of big data, the management of high-cost medicines, and workforce development.

The future of pharmacy practice heavily relies on technology. The availability of big data, artificial intelligence, and health systems will shape the development of pharmacy practice.